AIM:To investigate the procedure, feasibility and effects of laparoscopeassisted continuous circulatory hyperthermic intraperitoneal perfusion chemotherapy (CHIPC) in treatment of malignant ascites induced by peritone...AIM:To investigate the procedure, feasibility and effects of laparoscopeassisted continuous circulatory hyperthermic intraperitoneal perfusion chemotherapy (CHIPC) in treatment of malignant ascites induced by peritoneal carcinomatosis from gastric cancers. METHODS: From August 2006 to March 2008, the laparoscopic approach was used to perform CHIPC on 16 patients with malignant ascites induced by gastric cancer or postoperative intraperitoneal seeding. Each patient underwent CHIPC three times after laparoscopeassisted perfusion catheters placing. The first session was completed in operative room under general anesthesia, 5% glucose solution was selected as perfusion liquid, and 1500 mg 5 fluorouracil (5FU) and 200 mg oxaliplatin were added in the perfusion solution. The second andthird sessions were performed in intensive care unit, 0.9% sodium chloride solution was selected as perfusion liquid, and 1500 mg 5FU was added in the perfusion solution alone. CHIPC was performed for 90 min at a velocity of 450600 mL/min and an in flow temperature of 43 ± 0.2℃.RESULTS: The intraoperative course was uneventful in all cases, and the mean operative period for laparoscopeassisted perfusion catheters placing was 80 min for each case. No postoperative deaths or complications related to laparoscopeassisted CHIPC occurred in this study. Clinically complete remission of ascites and related symptoms were achieved in 14 patients, and partial remission was achieved in 2 patients. During the followup, 13 patients died 29 mo after CHIPC, with a median survival time of 5 mo. Two patients with partial remission suffered from port site seeding and tumor metastasis,and died 2 and 3 mo after treatment. Three patients who are still alive today survived 4, 6 and 7 mo, respectively. The Karnofsky marks of patients (5090) increased significantly (P < 0.01) and the general status improved after CHIPC. Thus satisfactory clinical efficacy has been achieved in these patients treated by laparoscopic CHIPC. CONCLUSION: Laparoscopeassisted CHIPC is a safe, feasible and effective procedure in the treatment of debilitating malignant ascites induced by unresectable gastric cancers.展开更多
For 100 patients with gastric cancer, intraoperative intraperitoneal perfusion(IOIPP)using double-distilled water(D.D.W)with hibitane 37℃ for 5 minutes was performed.The anticancer effects were assessed cytologically...For 100 patients with gastric cancer, intraoperative intraperitoneal perfusion(IOIPP)using double-distilled water(D.D.W)with hibitane 37℃ for 5 minutes was performed.The anticancer effects were assessed cytologically in pre-IOIPP and post-IOPP specimens of the abdominal effusion and/or lavaged peritoneal fluid.The radical gastrectomy was performed in 65 of 93 cases with advanced gastric cancer, shed cancer cells in peritoneal cavity were detected in 16 of 65 cases with pre-IOIPP(24.62%)and to 3 of post-IOIPP cases(4.62%).There was significant difference between the two groups(P<0.01) . Shed cancer cells were inactivated in vivo estimated by the trypan-blue staining technique in 7 cases with radical surgery.But the effect of the IOIPP on shed cancer calls was not significant in cases with peritoneal metastasis. Also there were shed cancer cells in peritoneal cavity of patients with SS cancer histologically before the IOIPP(15. 56%)and iatrogenic diffusion of cancer cells during operation(7/24)in thisarticle.The above results indicated that the IOIPP with hypo-osmolar solution containing hibitane, 37℃ for 5 min was indispensable and useful for the killing of peritoneal shed cancer cells in order to prevent postoperative peritoneal recurrence in patients with radical surgery of advanced gastric cancer regardless of conditions of serosal invasion.展开更多
基金Supported by Funds for Breakthroughs in Key Areas of Guang-dong and Hong Kong Projects, No. 2006Z1-E6041funds for Guangdong Provincial Science and Technology Programs, No. 2009A030301013
文摘AIM:To investigate the procedure, feasibility and effects of laparoscopeassisted continuous circulatory hyperthermic intraperitoneal perfusion chemotherapy (CHIPC) in treatment of malignant ascites induced by peritoneal carcinomatosis from gastric cancers. METHODS: From August 2006 to March 2008, the laparoscopic approach was used to perform CHIPC on 16 patients with malignant ascites induced by gastric cancer or postoperative intraperitoneal seeding. Each patient underwent CHIPC three times after laparoscopeassisted perfusion catheters placing. The first session was completed in operative room under general anesthesia, 5% glucose solution was selected as perfusion liquid, and 1500 mg 5 fluorouracil (5FU) and 200 mg oxaliplatin were added in the perfusion solution. The second andthird sessions were performed in intensive care unit, 0.9% sodium chloride solution was selected as perfusion liquid, and 1500 mg 5FU was added in the perfusion solution alone. CHIPC was performed for 90 min at a velocity of 450600 mL/min and an in flow temperature of 43 ± 0.2℃.RESULTS: The intraoperative course was uneventful in all cases, and the mean operative period for laparoscopeassisted perfusion catheters placing was 80 min for each case. No postoperative deaths or complications related to laparoscopeassisted CHIPC occurred in this study. Clinically complete remission of ascites and related symptoms were achieved in 14 patients, and partial remission was achieved in 2 patients. During the followup, 13 patients died 29 mo after CHIPC, with a median survival time of 5 mo. Two patients with partial remission suffered from port site seeding and tumor metastasis,and died 2 and 3 mo after treatment. Three patients who are still alive today survived 4, 6 and 7 mo, respectively. The Karnofsky marks of patients (5090) increased significantly (P < 0.01) and the general status improved after CHIPC. Thus satisfactory clinical efficacy has been achieved in these patients treated by laparoscopic CHIPC. CONCLUSION: Laparoscopeassisted CHIPC is a safe, feasible and effective procedure in the treatment of debilitating malignant ascites induced by unresectable gastric cancers.
文摘For 100 patients with gastric cancer, intraoperative intraperitoneal perfusion(IOIPP)using double-distilled water(D.D.W)with hibitane 37℃ for 5 minutes was performed.The anticancer effects were assessed cytologically in pre-IOIPP and post-IOPP specimens of the abdominal effusion and/or lavaged peritoneal fluid.The radical gastrectomy was performed in 65 of 93 cases with advanced gastric cancer, shed cancer cells in peritoneal cavity were detected in 16 of 65 cases with pre-IOIPP(24.62%)and to 3 of post-IOIPP cases(4.62%).There was significant difference between the two groups(P<0.01) . Shed cancer cells were inactivated in vivo estimated by the trypan-blue staining technique in 7 cases with radical surgery.But the effect of the IOIPP on shed cancer calls was not significant in cases with peritoneal metastasis. Also there were shed cancer cells in peritoneal cavity of patients with SS cancer histologically before the IOIPP(15. 56%)and iatrogenic diffusion of cancer cells during operation(7/24)in thisarticle.The above results indicated that the IOIPP with hypo-osmolar solution containing hibitane, 37℃ for 5 min was indispensable and useful for the killing of peritoneal shed cancer cells in order to prevent postoperative peritoneal recurrence in patients with radical surgery of advanced gastric cancer regardless of conditions of serosal invasion.
